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Healthcare IT Blog

Best Practices

Published on 03/19/2013 by Clay Sides
Category: Healthcare IT

Groucho Marx once said, “Does it hurt when you do that? Then don’t do that.” Little did he know he would become the Godfather of what we now describe as “best practices”.

What is a best practice?  Whose best practice is it?  Who owns the upkeep of the best practice?  How is it being monitored and adapted?  All are questions you should ask anyone in your organization when they throw up the “best practice” shield.  Just because company XYZ did it that way, or a gaggle of industry pundits say it’s the best thing since sliced bread, doesn’t mean it’s right for your institution.

When we at Park Place talk about implementing best practices, I often wonder if clients are watching us thinking, “If we watch them do it, we can start doing it ourselves and save some money.”   Although the practice would be right initially, best practices are constantly evolving.  A practice only stays a best practice because we own it and continue to update it.  Any “best practice” is really a moment in time as technologies and business drivers continue to change.

As a consultant, I am constantly changing, evolving and, dare I even say, getting smarter?  Yeah, that last part doesn’t come across right, but it’s true.  Let me ask you something; if you walked home from work every day and every day you stubbed your toe on the sidewalk in one particular spot, would you perhaps remember to be careful walking by there?  Probably.  You’ve learned a best practice. Now imagine the sidewalk is always under construction, undergoing repairs, upgrades, patches….the sidewalk would never look the same unless you continually walked it.  Sounds a little like a datacenter environment, doesn’t it?  VMware patches/updates, Windows updates/hotfixes, Citrix updates, VMware View updates, storage array code changes, networking switch firmware/OS updates…the list goes on and on.   All these things are conspiring against your current “best practices”.  If you aren’t benefiting from the troubleshooting and diagnosis with a dedicated team, you may not be aware of all the potential caveats.  In other words, unless you’re stubbing your toes on a daily basis and learning where to walk carefully, your best practice may be out of date.

Case in point: patch management.  Do you update your Windows servers regularly?  What about your ESX hosts? How do you handle VM’s and the VMTools updates?  I recently counseled two clients on the proper settings for VMTools updates.  One had never done them and was woefully out of date to the point they were having systems issues.  The other had done them a while back, but was changing their “best practice” to do them automatically because that is what VMware recommends.  I advised both customers to add the updates into their normal monthly update schedule and to run them MANUALLY.  Why? It’s our current best practice.  We’ve had experiences with the automatic setting causing reboots of the VM’s that MEDITECH wasn’t expecting and it caused issues with services that were starting and suddenly stopping on reboot.

By no means do I think everyone should come running to Park Place for every answer to every question.  MEDITECH customers are smart.  But if you have a large project in the works, or haven’t been as judicious in applying your patches and updates, maybe a Health Check or Performance Assessment is in order.  This will give you a view into your existing environment and provide you with a gap analysis derived from MEDITECH’s and PPI’s current best practices.

I’ve learned that Groucho was on to something; if you want to know if it’ll hurt when you do something, either do it and find out, or ask someone who’s done it!

And in case you’re curious, one client did not take our advice which resulted in some servers automatically rebooting while MEDITECH services were starting.  Yup, it hurt when they did that.

Clay Sides is a Senior Technical Consultant with Park Place International who specializes in helping customers hone in on their true objectives to ensure the biggest return on their investment. Clay gets satisfaction from working with customers to discuss their needs and provide consulting services that best address those needs. Identifying performance bottlenecks, assisting with building and implementing strategic plans for growth and sustainability, as well as recoverability, are all his specialties. Clay has been working in Information Systems since 1989, having spent time with United Technologies, Texas Instruments, Acer America, Palm Computing, Gateway and most recently, 5 years with JJWild/Perot/Dell. When asked, Clay says his favorite part of his current endeavor, is seeing the moment of realization in a customers’ eyes when he’s able to communicate a complicated plan, or concept, in terms they understand; “It’s a rush when you actually see you’ve been able to help someone understand something. Their stress seems to almost float away at the moment of realization.”



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